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Erschienen in:
01.11.2011
Risk Factor Analysis of Postoperative Complications After Robotic Rectal Cancer Surgery
Erschienen in: World Journal of Surgery | Ausgabe 11/2011
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Background
The robotic system has been adopted as the new modality for minimally invasive surgery for rectal cancer. However, analysis of risk factors for complications after robotic rectal cancer surgery (RRS) has been limited. This study aimed to identify the risk factors for complications after RRS.
Methods
The records of 389 consecutive patients who underwent RRS between June 2006 and October 2010 were retrieved from our prospectively collected database.
Results
The overall complication rate was 19%. The most common complication was anastomotic leakage (7.0%), followed by voiding difficulty, intrapelvic abscess, and ileus/obstruction. Multivariate analysis revealed the following as risk factors for postoperative complications: male gender, history of previous abdominal surgery, and lower tumor level (hazard ratio [HR] = 1.8, 95% confidence interval [CI] = 1.0–3.1, p = 0.041; HR = 2.3; 95% CI = 1.2–4.6, p = 0.012; and HR = 1.9, 95% CI = 1.1–3.3, p = 0.020, respectively). With regard to pelvic septic complications, lower tumor level, large tumor size, and preoperative chemoradiation remained variables that retained their statistical significance in multivariate analysis (HR = 2.6, 95% CI = 1.1–6.1, p = 0.029; HR = 2.7, 95% CI = 1.1–6.1, p = 0.017; HR = 2.9, 95% CI = 1.3–6.5, p = 0.007, respectively). The rate of postoperative complications was not influenced by the difference in laparoscopic surgery experience or the technique of robotic surgery.
Conclusion
Surgeons should be more cautious with these patient factors to optimize the benefits of robotic rectal resection.